Originally published 7/5/2022
As time goes by, findings into the relationship between alcohol use and prostate cancer (PCa) continue to be mixed. Now a multicenter team of authors explains why: many studies focus on the amount and duration of consumption without distinguishing types (beer, wine, spirits). Thus, they analyzed a large population of men (4676 non-PCa men and 5353 PCa patients) with the aim of evaluating “… intake patterns of total alcohol and three types of alcoholic beverage (beer, wine, and spirits) by PCa risk and aggressiveness status.”[i]
They found that heavy alcohol consumption (across all types) was similar between patients and non-patients, suggesting that quantity may be less a problem than type of beverage. They found type-related differences: “… PCa patients were likely to drink more wine and spirits than non-PCa men. Patients with aggressive PCa drank more beer but not wine and spirits.”
Does this mean beer interacts differently with prostate tissue in some way? Interestingly, they found that PCa patients who were heavy wine drinkers tended to have less aggressive PCa.
Having established different PCa patterns linked with specific alcohol types, they conclude, “By understanding the intake of alcoholic beverage types for PCa patients, custom alcohol intervention by beverage types can be developed and promoted.”
Developing such programs seems unlikely. We suspect the issue of alcohol and PCa will continue to go unrecognized, since patients are generally unaware of the relationship, and doctors don’t routinely ask about drinking habits at the time of diagnosis. See the blog below for more information.
What would life be without pleasure? It “contributes importantly to happiness and is central to our sense of well-being.”[ii] Humans gain natural pleasure from many activities and relationships, and good feelings are registered in our brains and bodies in rewarding ways. Besides feel-good behaviors and choices, there are substances that provide pleasurable sensations. However, as with virtually all sources of pleasure, they can pose risks if misused.
Alcoholic beverages are associated with pleasure. Beer, wine and liquor can give or enhance a sense of happiness. People drink for countless reasons: social drinking at parties and special celebrations; relaxing with a beer or glass of wine after a busy day; a cocktail (or two) when out for dinner; visiting a vineyard to taste their wares on vacations. For responsible light-to-moderate drinkers, especially those who don’t drink and drive, or who don’t get smashed and behave irresponsibly, there are few risks in exchange for enhanced enjoyment. Nonetheless, drinkers are imbibing a toxic substance that is potentially harmful.
Consuming it puts a burden on the organs that break it down into harmless water and carbon dioxide: the liver does the heavy lifting of processing it, and the rest is excreted through the lungs (think of breathalyzers and “alcohol breath”), kidneys, and sweat. More importantly, according to a Canadian health site:
Alcohol is absorbed very quickly by the blood and spreads easily to all organs because alcohol molecules are very tiny. Once it’s in the bloodstream, alcohol spreads to all parts of the body and goes into all tissues containing water. Because alcohol is carried by blood, it is delivered particularly quickly to organs with many blood vessels, such as the brain, lungs, and liver.
I want to point out blood is fed to the prostate gland by arteries and drained by veins, including the neurovascular bundles that play a key role in erectile function. Thus, the prostate is not entirely immune from the toxic effects of alcohol.
Increased risk of prostate cancer (PCa)
This raises questions about a possible association between alcohol consumption and prostate cancer risk. There are indeed many published studies on this topic, with mixed results. Here are three papers for which the authors conducted a review of the literature, from earliest to most recent:
- A 2013 survey of alcohol use and the risk of several organ cancers (e.g., esophagus, colorectal, pancreas, breast, and central nervous system) concluded that moderate to heavy consumption increased the risk of PCa.[iii]
- A 2016 review dedicated only to PCa risk selected 27 high quality studies out of 340 potential publications. Their conclusion is rather stunning. “Our study finds, for the first time, a significant dose-response relationship between level of alcohol intake and risk of prostate cancer starting with low volume consumption (>1.3, <24 g per day). This relationship is stronger in the relatively few studies free of former drinker misclassification error. Given the high prevalence of prostate cancer in the developed world, the public health implications of these findings are significant.”[iv] (Interested readers, including light drinkers, may want to read the full paper.)
- For readers who are still skeptical, a 2022 review announces that it’s “time to draw conclusions”. This paper thoroughly delves into the biochemical effects of alcohol on the prostate gland and related systems. It considers other factors such as physical and lifestyle quality, personal and family history, and duration/quantity of alcohol consumption. They found that “high alcohol intake, especially binge drinking, is associated with increased risk for PCa” and that any alcohol consumption is “directly linked to PCa lethality as it may accelerate the growth of prostate tumors and significantly shorten the time for the progression to metastatic PCa.” They recommend that men diagnosed with PCa immediately quit alcohol![v] (Again, the full article can be found here.)
Light to moderate drinking is certainly a pleasure for most alcohol consumers. Humans are pleasure seekers, and most of us don’t want to think that pleasures may pose trade-offs. An occasional drink surely does not raise the mortality stakes; in fact, demographic research into global regions where people often live to be 100 years old (the so-called blue zones) finds that drinking wine can be part of a long, happy life when done the right way in the right context:
Living to 100 doesn’t have to mean a strict regimen of steamed vegetables and joyless meals. A healthy, balanced, and stress-free life includes happy hours, time spent with family and friends and the occasional glass of wine with delicious dinners. You can consume alcohol and live to a happy 100, even up to one drink daily for women, two for men. … People in four original blue zones areas drink alcohol moderately and regularly. The trick is to drink one to two glasses per day with friends and/or with food. And no, you can’t save up all week and have 14 drinks on Saturday.[vi]
It is our recommendation that if you are diagnosed with PCa, talk to your doctor about quitting alcohol. Other than that, have annual wellness exams that include a PSA test; know your family history or other risk factors for PCa; and be conscious of when, how much, and in what situations you choose to drink. Here’s to your health and long life!
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
References
[i] Lin HY, Tseng TS, Wang X, Fang Z et al. Intake Patterns of Specific Alcoholic Beverages by Prostate Cancer Status. Cancers (Basel). 2022 Apr 14;14(8):1981.
[ii] Kringelbach ML, Berridge KC. The Neuroscience of Happiness and Pleasure. Soc Res (New York). 2010;77(2):659- 678.
[iii] de Menezes RF, Bergmann A, Thuler LC. Alcohol consumption and risk of cancer: a systematic literature review. Asian Pac J Cancer Prev. 2013;14(9):4965-72.
[iv] Zhao J, Stockwell T, Roemer A, Chikritzhs T. Is alcohol consumption a risk factor for prostate cancer? A systematic review and meta-analysis. BMC Cancer. 2016 Nov 15;16(1):845.
[v] Macke AJ, Petrosyan A. Alcohol and Prostate Cancer: Time to Draw Conclusions. Biomolecules. 2022;12(3):375.
[vi] https://www.bluezones.com/2017/08/longevity-link-how-and-why-wine-helps-you-live-longer/
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
